# WAL-MART STORES EAST, LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Walmart Vision Center 30-3564
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609643543
- **Authorized official:** MATTHEW MCMULLIN (DIRECTOR)
- **Authorized official phone:** (479) 371-8711

## Contact information

- **Practice address:** 2101 BLAIR MILL RD, WILLOW GROVE, PA 19090-1751
- **Practice address phone:** (215) 659-2460
- **Practice address fax:** (215) 659-5209
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 371-2827
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | — | NULL | Yes |
| 156FX1800X | Optician | — | — | Yes |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 12/11/2023
- **Last updated:** 12/11/2023